Case Manager Position Available In Allegheny, Pennsylvania

Job Title:

Case Manager Location:

Pittsburgh, PA (Hybrid)

Job Summary:

We are seeking a compassionate and proactive Case Manager to support patients with chronic illnesses. In this role, you will help patients navigate the complexities of their treatment journey, from securing insurance approvals to coordinating with healthcare providers and pharmacies. Your work will directly contribute to improving access to therapy and patient outcomes.

Key Responsibilities:

Serve as the primary point of contact for patients within an assigned territory, assessing their needs and guiding them through treatment and insurance processes.
Collaborate with internal teams, pharmaceutical representatives, healthcare providers, and insurance companies to resolve issues and ensure timely access to therapy.
Address case-specific challenges using sound judgment and compliance with company policies and regulatory requirements.
Coordinate benefits investigations, insurance approvals, prescription triaging, and enrollment in copay or patient assistance programs.
Educate patients and healthcare providers on therapy initiation requirements, insurance limitations, and disease or product information.
Maintain detailed records of all patient interactions, insurance coverage data, and case progress using internal systems.
Stay informed about reimbursement procedures, payer trends, financial assistance options, and relevant billing or coding nuances.
Lead and contribute to special projects, continuous process improvement, and knowledge sharing with peers.

Skills & Qualifications:

Bachelor’s degree (or equivalent) in Health Care, Social Work, Nursing, or related field preferred.
At least 3 years of recent experience in case management, with knowledge of ethics and legal aspects of patient care.
Background in home care, utilization review, social work, or patient advocacy preferred.
Strong understanding of health insurance coverage, reimbursement processes, and industry regulations.
Excellent communication, mediation, and problem-solving skills.
Ability to manage sensitive issues, handle multiple tasks independently, and work effectively in a team.
Computer proficiency and experience with data entry systems.
Spanish language skills are a plus.

About SSi People:

With over 26 years of industry experience, SSi People has built its reputation and expertise on putting people first. Everything we do works toward delivering an exceptional experience for our consultants, our clients, and our internal team. Through a genuine commitment to people in everything we do. We have developed refined processes and a stellar internal team to deliver talent quickly. More importantly, we focus on building long-term relationships, not transactions. Putting people first is just what we do well.
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